Among the issues most commonly discussed are individuality, the rights of the individual, the limits of legitimate government, morality, history, economics, government policy, science, business, education, health care, energy, and man-made global warming evaluations. My posts are aimed at intelligent and rational individuals, whose comments are very welcome.

"No matter how vast your knowledge or how modest, it is your own mind that has to acquire it." Ayn Rand

"Observe that the 'haves' are those who have freedom, and that it is freedom that the 'have-nots' have not." Ayn Rand

"The virtue involved in helping those one loves is not 'selflessness' or 'sacrifice', but integrity." Ayn Rand

02 April 2010

Krugman: Advisory Panels will Reduce Costs with Rationing

Paul Krugman, the Progressive economist writing for the New York Times and a major spokesman for the Progressive viewpoint, said on ABC News Sunday during the show "This Week" that

The People on the right, they're simultaneously screaming, 'They're going to send all the old people to death panels,' and 'It's not going to save any money.
The advisory panel which has the ability to make more or less binding judgments on saying this particular expensive treatment actually doesn't do any good medically and so we are not going to pay for it. That is actually going to save quite a lot of money. We don't know how much yet. The CBO gives it very little credit but, but most, most of the health care economists I talk to think that's going be a really, uh a really major cost saving.
Krugman is saying that the ObamaCare program will have to ration medical care more than it presently is rationed in order to save money.  It will do so with advisory panels whose decision is close to that of the Grim Reaper in finality.  The patient and the doctor and the patient's family will have little to no say.  The advisory panel's decision is "more or less binding."  It is dictated.

Note the sleight-of-hand in his first statement in which he concatenates the critic's statement that rationing will occur and it will result in more deaths with their statement that ObamaCare will cost a lot more money and raise premium prices in such a straw-man way as to make the statements appear to be contradictory.  Yet, it is elementary, my dear Krugman, to note that the latter statement of ObamaCare raising net costs does not mean that ObamaCare will not take desperate measures to ration really important care in life and death situations in order to free up money to pay for the much added costs of people seeing a care provider for their many sniffles.

So, as I have noted many times, ObamaCare must ration medical services.  Of course medical services are always rationed.  They used to be rationed by a combination of the ability to pay and the willingness of doctors to provide the truly needy with free or greatly reduced cost care.  Now they will be rationed by an Obama advisory panel of government bureaucrats, who will come between the patient and his family and the patient's doctor, who will not really be the patient's doctor at all, because the doctors will all be owned by the government.  Now, how many times did Obama and his horde of allies tell us that "No one will come between you and your doctor."?????

While it is true that medical care is and always must be rationed, there are very important further differences in which care will be rationed.  ObamaCare will measure its success in the number of doctor visits made to address the sniffles.  There will be many more such visits to the doctor than now because people will not have to pay out of their own pockets for those visits.  They have also committed ObamaCare to much more preventive medicine, even though this also drives cost up, contrary to their claims.  The extra sniffles visits and the preventive medical care will drive the total cost of medical care sharply upward.  At least partially compensating savings will have to be made.  Now, where can savings be made?  Given the ObamaCare commitments, the only time to save lots of money is when most medical expenditure has occurred in the past.  Very rationally, this has been when the care was most needed to extend life and is usually encountered with older people or babies.  Obama and his friends have made it very clear in unguarded moments in the past, that they do not like the fact that so much medical money is spent on babies and the elderly.  They have argued that babies and the elderly have little social value.  They have complained very bitterly about this, but by hiding it in general statements such as Americans spend too much on health care during the recent debates.

So, the advisory panel will look at cost to life extension and future life quality and decide what procedures are worth it, given the budgetary constraints of ObamaCare.  Procedures that were worth the effort to doctors, their patients, and their insurance companies will now be deemed not worth it.  There must be added savings to compensate for the sniffles and the preventive medicine.  The advisory panel will have to decide that grannies and babies who used to be worth the medical effort to save are not now worth the medical effort to save.  However much, the Progressives do not want these panels to be called Death Panels, they are tasked with the necessary job of pulling the plug on granny or your newborn baby.  The plug will have to be pulled much more frequently than we as free people ever allowed it to be pulled.  Now that all value decisions are to be made on a collective basis, your granny and your baby are worth much less in the future than they were in the past.

So, the reality is that just as the Progressive tries to hide the fact he is a Socialist behind a deceiving name implying he is the Angel of the Future Better Society, his Advisory Panel is exactly what Sarah Palin called the Death Panel.  The Advisory Panel serves the purpose of the Grim Reaper, who must cull society of its weak members.  The Weak are Expensive and not Worth it to the Collective.  And on and on, they will insist that we are not fair in identifying them as Socialists.

Our granny may be weak, but when she was our granny, she was loved and she was valuable.  Under ObamaCare, our granny is just a nationalized wee little bit of the Collective.  She is no longer your granny.  She is old and weak and not much regarded by the Collective.  Granny is now very expendable.  So is your newborn baby, if your baby has a serious health problem.  Get used to it.  Or, man the barricades and fight as you have never fought before to save your granny and your future babies!

This is not the time for Summer Soldiers, this is the crisis that can only be met by Winter Soldiers!  We must stand for the equal, sovereign rights of the individual to life, liberty, and the pursuit of happiness.  We must realize that our individual rights and our individual values mean nothing to any too powerful government.  They never have in all of history.  Our Founding Fathers and the Framers of the Constitution knew this very well.  They gave us a Constitution which tightly constrained the federal government with very limited powers in order to protect our individual rights and values.  Our federal government has pushed and pushed to expand its powers far, far beyond those given to it in this wonderful Constitution.  The People have not stopped them in this expansion of government power to this time.  Will you finally become the Winter Soldier for Freedom to save your granny and your future baby?  If you will not, you consent to their being expendable.


KZ said...

"Rationing" in extreme cases, where your life is on the line, means "death panels."

Charles R. Anderson, Ph.D. said...

Absolutely right KZ.

Anonymous said...

The military needs to wake up and keep their oath. They are the ones with the authority and means to protect us from the enemy within that is subverting and treacherously trampling upon our constitution. Keep your oath! THIS IS A TEST. Only the worthy will be spared. All are watching.

Charles R. Anderson, Ph.D. said...

We have a long tradition of the military not becoming involved in our domestic politics. While the military are pledged to protect the Constitution, it is the duty of all of us to do that also. Our Representatives in the House, our Senators, and our President are supposed to protect the Constitution and to be scrupulous in not exceeding their powers as carefully enumerated in the Constitution. The Supreme Court is also tasked with seeing that they do not exceed those powers. The states also have a duty to see to it that the federal government does not exceed its powers. Each of these government bodies will do their duty, if and only if, We the People understand the principles of the Constitution and its presumption that every individual has a sovereign, equal, and unalienable right to life, liberty, and the pursuit of happiness and the government is never to transgress these individual rights. Our individual rights are many, the powers of government are few. But, for a long time the People have been asleep. If they will finally stand up for their own rights, we can win them back in the 2010 and 2012 elections as we are supposed to. A military coup would be an awful outcome. We need to do this right. If we want a good government, it can only be made good by the People acting on rational principles and demanding their rights from their government.

Anonymous said...

Um, health care is currently rationed. It's rationed depending on how many dollars you have. I don't really see how rationing on the basis of a government bureaucrat is any worse/ more heartless than rationing on the basis of ability to pay. So please stop this nonsense about the start of "health care rationing." It's a shift in how it's rationed, not a beginning of rationing.

We also have to admit that insurance costs are so high because naive/scared/hypochondriac people go to the doctor, and the doctor knows that if the patient has good insurance, he can run a whole bunch of unnecessary expensive tests.

The solution, if you ask me, would be to break the monopoly the AMA and the doctors have on providing care. Let people go straight to pharmacists to drugs, midwives for childbirth, uncertified tradtional medicine providers or outright quacks if they want to. Let me tell you, doctors bills sure would go down if they actually had to compete.

Charles R. Anderson, Ph.D. said...

The number of doctors, the number of medical facilities, the amount of medical equipment, and the amount of medical supplies are all limited. As with all economic factors, their use is rationed, which I have made perfectly clear. I have also made it clear that they may be rationed by payment in goods and services or by the government's use of force. You believe that anything needed or wanted by someone cannot be denied them due to a lack of money since that would be heartless, so you are just as happy that a doctor's service should be rendered at the point of a gun. Now, that is simply slavery and that is truly heartless. Free trade allows people to take care of their needs on a voluntary, non-servitude basis. It allows the optimized use of limited resources to meet people's needs and desires as they evaluate those needs with their limited payment capabilities. This is not cruel, this is simply a recognition that reality does not offer us all that we might want. If we really want something, then we should earn it, not steal it.

You have opted for stealing and claim a superior heart because of it. This is a gross inversion of morality. If you propose this for medical care, than the principle that force makes right leads us to the chaos of ganged warfare. A return to the Dark Ages is the logical conclusion. The strong and ruthless simply take what they want. Sure, you probably think you will maintain some kind of democracy, but without strong moral principles and morality, such tyrannical democracies do not last long. Not that it really matters, because any tyranny is still horrible, including a democratic tyranny. Such democratic tyrannies were wisely seen by the Founders and Framers of the Constitution to be as bad as any other tyranny.

Hypochondriacs sure do contribute to high insurance costs, as do Medicaid and Medicare, ridiculously high tort costs, state mandates on insurance coverage, government limits on building hospitals, and licensing requirements for medical care providers.

Only about 15 - 17% of physicians are members of the AMA, so it has less influence than you perhaps think.